Page 124 - Physiology and Pathophysiology MNU 2024-2025 نظرى

Clinical pharmacy 2024/2025 Level 2 Pharm D Physiology and Pathophysiology
(MD303)

▪ Profound diuresis (The diuretic phase) occurs during the healing process when the epithelial
cells of the tubules have regenerated but are still incapable of selective reabsorption and
secretion.

▪ Diuresis may lead to acute dehydration, complicating the existing high plasma urea, acidosis,
and electrolyte imbalance.
▪ If the patient survives the initial acute phase, a considerable degree of renal function is usually
restored over a period of months.
2. Accumulation of urea (uremia) and other metabolic waste products.
3. Electrolyte imbalance
4. Acidosis due to disrupted excretion of hydrogen ions.

B) Chronic renal failure:
▪ This is reached when irreversible damage to nephrons is so severe that 75% of renal function
has been lost and the kidneys cannot function effectively.
▪ The main causes are Glomerulonephritis, Chronic pyelonephritis, Diabetes mellitus,
Hypertension.

▪ The effects are:
1- Reduced glomerular filtration rate
2- Reduced selective reabsorption and secretion
3- Glomerular fibrosis, which interfere with blood flow.
These changes have a number of effects on the body.

4- Renal calculi (kidney stones)
▪ Form mainly in the renal pelvis or calyces but can form anywhere in the kidneys.

▪ Composed mainly of calcium salts, uric acid and cystine.

➢ Although the exact etiology is unclear, Predisposing factors include
Dehydration, Changes in urine pH, Decreased urine production, Excess salt
secretion, Gout, Obstruction of urine flow.

| P a g e 87